Tourette's Dropped From List Being Considered For Medical Marijuana Use

Connecticut's medical marijuana program could be expanded to add more ailments. Find out which ones.

— Connecticut's Medical Marijuana Program could be broadened to allow patients who suffer sickle cell disease, chronic pain after back surgery and severe psoriasis or psoriatic arthritis.

Tourette's disorder, however, will not be added to the list of debilitating medical conditions that allow a patient to buy and use medical marijuana.

On Wednesday, the marijuana program's Board of Physicians voted on petitions seeking to add four debilitating conditions to the existing list of roughly a dozen medical ailments that allow a person to buy and use medical marijuana. The doctors, navigating the barely charted waters of treating marijuana as a pharmaceutical drug, debated the rationale for adding one medical condition and not another.

Unlike pharmaceuticals that need approval by the U.S. Food and Drug Administration after clinical trials, marijuana use for medical ailments is a new process in Connecticut. Anyone can petition the state Department of Consumer Protection to add an ailment to the list of qualifying medical conditions, and the matter is reviewed by the four-person board of physicians.

The board voted to recommend adding sickle cell disease; severe psoriasis and psoriatic arthritis; and post-laminectomy syndrome with chronic radiculopathy, which is recurring back pain after surgery. They voted unanimously against adding Tourette's. a disorder of the nervous system that produces involuntary and unusual movements or sounds.

The recommendations now go to Consumer Protection Commissioner Jonathan A. Harris. If Harris decides to add any of the medical conditions, he would draft a regulation that would then go to another public hearing before moving to the General Assembly's regulation-review committee for the ultimate decision. The timeline for approval is unclear. It could take months or years.

State law currently allows Connecticut residents 18 or older to register as medical marijuana patients if they have any of the following conditions: cancer, glaucoma, HIV or AIDS, Parkinson's disease, multiple sclerosis, intractable spasticity related to nerve damage in the spinal cord, epilepsy, cachexia, wasting syndrome, Crohn's disease or post-traumatic stress disorder.

Even though several more conditions are now moving forward with the blessing of doctors, the Board of Physicians talked openly about the difficulty of establishing parameters for medical marijuana because of a lack of clinical studies.

"On the one hand, if we insisted … on rigorous, double-blind, control trials, then we would never approve anything," said Dr. Godfrey Pearlson, one of the four medical doctors on the board. "On the other hand, if we only accepted anecdotal evidence, then we would approve everything, and there would be no need for these sorts of hearings. So, we want to avoid both of those."

Of the four, Dr. Deepak Cyril D'Souza most resisted adding to the existing list of medical conditions.

At one point, the board voted 3-1 to add sickle-cell disease — with three of four doctors discounting the lack of clinical studies to support marijuana as a valid treatment. But the board unanimously declined to add Tourette's, citing a lack of evidence that marijuana would reduce physical tics or the anxiety the precedes tics.

"This is very new … this is the first time we're doing this," D'Souza said, asking his fellow board members, "Moving forward, can we all think about how we can apply the same standards of evidence to all the conditions because it sounds like the three of you were not comfortable with Tourette's because there wasn't any evidence. … I wasn't quite sure how that differed from our discussion about sickle-cell disease. …"

Regarding sickle-cell disease, Dr. Jonathan Kost said one factor he considered is that marijuana might allow patients who currently use high doses of opiate pharmaceutical drugs to cut back their use. The toxicity associated with cannabis is markedly lower than the toxicity associated with opiates, Kost said. Opiates are associated with many deaths, and marijuana virtually none, he said.